Individual
DR. STAN R HEINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1540 OAKDALE RD, MODESTO, CA 95355-3306
(209) 577-3792
(209) 577-6951
Mailing address
1540 OAKDALE RD, MODESTO, CA 95355-3306
(209) 577-3792
(209) 577-6951
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
25901
CA
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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